It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • Suboxone film starting dose for pain?

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 12-06-2015, 09:41 PM   #1
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Suboxone film starting dose for pain?

    I am on 600 mg Lyrica (yes max dose), 50 mg Amitryptaline, 200 mg tegretol, 5 mg valium, 10 mg baclofen, 1 g Chlorzoxazone, and phenibut when I want to take it. My pain is still not being helped much, even with all these meds. I was an addict and have been sober 8 years, but have been mixing my phenibut and valium to feel good 2-3 times a week. The dr is seeing this as addictive behavior and doesnt want me to relapse. So, he wants me to stop the valium, baclofen,and phenibut and replace it with Suboxone.

    I am opiate naive and have never really gotten high on opiates before - I have no tolerance to them. He prescribed me 2 mg, 3 times per day. Now, I know this is wayyyy to high of a dose for an opiate naive person. What is a good starting dose for pain?

    Last edited by Administrator; 12-06-2015 at 11:27 PM.

     
    Sponsors Lightbulb
       
    Old 12-07-2015, 06:31 AM   #2
    tortoisegirl
    Senior Veteran
    (female)
     
    Join Date: Mar 2012
    Location: Washington
    Posts: 1,204
    tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
    Re: Suboxone film starting dose for pain?

    I think its a red flag your doctor prescribed a highish dose and didn't give you starting instructions. There is not technically a starting dose for opioid naive patients as it isn't indicated for that. Did you not tell him you were concerned that was too much? Did he give you taper instructions on the Valium? (Typically it cannot be stopped without tapering)

    If at all possible I would follow up with your doctor. If not, your pharmacist can be a good resource. Suboxone strips can be cut. Ensure you read the full prescribing info on how to take them, potential side effects, signs of too high of a dose, etc.

    If your doctor doesn't answer your questions thoroughly, you may want to consider a new one. Suboxone is a serious med and shouldn't be taken lightly. Might there still be other medications to try?

    Its a huge jump to go to Suboxone when you haven't even been on as needed opioid pain meds. It must be taken daily and you will become physically dependent on it after awhile. Like any med there are no guarantees it will help your pain. I would really recommend considering the pros and cons. Especially with a new doctor where should still be other options left. Best wishes.

    Last edited by tortoisegirl; 12-07-2015 at 06:32 AM.

     
    Old 12-07-2015, 10:25 AM   #3
    backhurtz
    Senior Veteran
    (female)
     
    backhurtz's Avatar
     
    Join Date: Oct 2008
    Location: NY, USA
    Posts: 818
    backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
    Re: Suboxone film starting dose for pain?

    Quote:
    Originally Posted by streetsk8er794 View Post
    I am on 600 mg Lyrica (yes max dose), 50 mg Amitryptaline, 200 mg tegretol, 5 mg valium, 10 mg baclofen, 1 g Chlorzoxazone, and phenibut when I want to take it. My pain is still not being helped much, even with all these meds. I was an addict and have been sober 8 years, but have been mixing my phenibut and valium to feel good 2-3 times a week. The dr is seeing this as addictive behavior and doesnt want me to relapse. So, he wants me to stop the valium, baclofen,and phenibut and replace it with Suboxone.

    I am opiate naive and have never really gotten high on opiates before - I have no tolerance to them. He prescribed me 2 mg, 3 times per day. Now, I know this is wayyyy to high of a dose for an opiate naive person. What is a good starting dose for pain?
    I have to agree with the other poster. Suboxone is used to treat addiction and at the dosage level being prescribed for you, that is used as Suboxone maintenance therapy .
    There are other pain medications that contain the buprenorphine without the naloxone that are prescribed for pain treatment purposes. Suboxone is not prescribed at the dosage this doctor is giving you for pain management.
    It sounds like you went to a sub prescriber and not a pain management doctor.
    Even in the rare cases where it is used for pain treatment in active addiction, it is prescribed at much , much lower doses,because there is a ceiling effect in its ability to reduce pain.

     
    Old 12-07-2015, 12:42 PM   #4
    tortoisegirl
    Senior Veteran
    (female)
     
    Join Date: Mar 2012
    Location: Washington
    Posts: 1,204
    tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
    Re: Suboxone film starting dose for pain?

    To clarify, I have no opinion on that dose for addiction vs. pain, only agree with the original poster that it may be too high for someone who is opioid naive. High doses can be used for pain management and the ceiling is closer to 32mg/day. High doses actually have to be used to keep the patient comfortable if they transferred from a high dose of another opioid, although it may be possible to taper down afterwards.

    I was on as much as 24mg/day when I tried it (although I started lower) due to my tolerance (had continuing withdrawal) and to try to get some pain relief, but had no luck. So, I'm back on Methadone. Best wishes.

     
    Old 12-08-2015, 07:51 AM   #5
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Re: Suboxone film starting dose for pain?

    As far as "following up with my dr", the only option I have is to make another appointment to see him and ask him then. That is a lot of time and money. For now, I'm going to start with .25 mg / day and see how that helps my pain. I will have my roommate hold on to the rest of them. Next time I see my doc (I have to see him every month for a refill) I will bring my concerns to him.

     
    Old 12-08-2015, 04:02 PM   #6
    tortoisegirl
    Senior Veteran
    (female)
     
    Join Date: Mar 2012
    Location: Washington
    Posts: 1,204
    tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
    Re: Suboxone film starting dose for pain?

    You should be able to call your doctor, asking to speak to their medical assistant (or leave them a message). They can then talk to your doctor and ideally someone gets back to you. Or, you can ask to be seen sooner (but yes that is another visit cost). Discussing this with your pharmacist is a great free & immediate option. Best wishes.
    __________________
    Kate
    constant headache since 2006

     
    Old 12-08-2015, 05:36 PM   #7
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Re: Suboxone film starting dose for pain?

    When people say speak to "your" pharmacist, I never know what they mean. I always get a different pharmacist when I go to CVS. Its not like I have one guy there that gives a **** about me, ya know? I'm using this language because I feel like the pharmacists really dont care. I went to CVS and asked to speak to one and he didnt know jack. I told him about my predicament and he said, "I dont know that there are any guidelines. Its on a case by case basis and its between you and your doc". So I left.

     
    Old 12-10-2015, 06:47 AM   #8
    tortoisegirl
    Senior Veteran
    (female)
     
    Join Date: Mar 2012
    Location: Washington
    Posts: 1,204
    tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
    Re: Suboxone film starting dose for pain?

    It definitely varies. Usually smaller independant pharmacies are better. For example, most of them know me by name at my pharmacy and I've only dealt with two pharmacists. Yes there will be multiple pharmacists, but at least one there that day available to consult with. You can even call up or visit a pharmacy you don't use and try to find someone helpful. That is best done when they aren't busy though.

    They can't tell you to change your dosing that the doctor prescribed, but they should be able to tell you if there is reason for concern with the dose prescribed for you being opioid naive. Typically a pharmacist would actually call your doctor if they had a concern about a med dose, interaction, etc, before even dispensing it. With Suboxone though, its common to be transitioning from un-prescribed meds, so they may have not looked much at the dose. So have you started on it yet? Best wishes.

     
    Old 12-10-2015, 07:30 AM   #9
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Re: Suboxone film starting dose for pain?

    I have not started on the suboxone yet. I'm in finals week at college, so don't want any drastic changes in my Meds for finals. Also, I've been procrastinating starting the med due to fear - what will happen? Will I become addicted and anxiety ridden all the time? Will I be so tired I get nods all the time? Or will it be great as a painkiller, antidepressant or anxiolytic? These are all questions I'm afraid of finding out. I'll start in 2 weeks.

     
    Old 12-10-2015, 10:39 PM   #10
    backhurtz
    Senior Veteran
    (female)
     
    backhurtz's Avatar
     
    Join Date: Oct 2008
    Location: NY, USA
    Posts: 818
    backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
    Re: Suboxone film starting dose for pain?

    You really do need to discuss your concerns regarding the dosage with the dr. that prescribed it.
    There is no way that anyone here can give you a "safe"starting dose, especially given your opiate naive status and it would be reckless , irresponsible and dangerous to do so.
    The only thing I am willing to state is the dosages are totally different when used for pain management, because there is a ceiling effect to the pain relieving properties, then the dosage you are being prescribed.
    You could easily overdose at the dosages being prescribed, and you need to consult with your dr., before going ahead with this.

    Last edited by backhurtz; 12-10-2015 at 10:40 PM.

     
    Old 12-13-2015, 10:40 AM   #11
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Re: Suboxone film starting dose for pain?

    I started at .25 mg and wow, it got me pretty messed up. However, I know I'm going to need a larger dose because the pain is not gone. I can't imagine a larger dose based on how zooted .25 mg got me. How do I solve this issue?

     
    Old 12-13-2015, 01:28 PM   #12
    backhurtz
    Senior Veteran
    (female)
     
    backhurtz's Avatar
     
    Join Date: Oct 2008
    Location: NY, USA
    Posts: 818
    backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
    Re: Suboxone film starting dose for pain?

    As has been said several times, contact your doctor regarding your questions. We can not answer them for you.
    Suboxone is not a medication to play around with, and you need professional guidance in dosing so you don't overdose.

     
    Old 12-13-2015, 05:00 PM   #13
    tortoisegirl
    Senior Veteran
    (female)
     
    Join Date: Mar 2012
    Location: Washington
    Posts: 1,204
    tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
    Re: Suboxone film starting dose for pain?

    I agree. It would be reckless of us to give you any medical advise, despite this being significantly less than the dose your doctor prescribed. Best wishes.
    __________________
    Kate
    constant headache since 2006

     
    Old 12-14-2015, 03:46 PM   #14
    streetsk8er794
    Junior Member
    (male)
     
    Join Date: May 2015
    Posts: 45
    streetsk8er794 HB User
    Re: Suboxone film starting dose for pain?

    Let me just say this. Despite my insistent claims that I've already spoken to my Dr AND later his assistant on the phone, you all still wanted me to take his advice. A doctor once thought I had adrenal fatigue and prescribed me high dose cortisone for 6 months. My uncle thought it sounded fishy and asked for a second opinion. Turns out the first doctor was wrong. If I had listened to my first dr I wouldve had a myriad of problems from that corticosteroid.

    Back to the present. My dr told me to take 2 mg three times a day. Even the pharmacist said that was fine. I dont trust doctors, never have. Being an engineer in school and friends with some in med school, I see that its all wrote memorization for the most part. I'm smarter than many of my doctors in certain fields (I'm not claiming to know more about the medical field in general). Anyways, I started with .25 mg and I was so high I could barely walk. I was dizzy, having closed eye visualizations, and feeling sick. I could NOT have even imagined taking 2 mg. I feel like I would have overdosed, or at least had a very uncomfortable time.

    So, for those of you who think your doctor is God, wake the hell up. I googled around and found a few anecdotal stories of people starting at too high a dose and having bad reactions. But it took me longer to find than if you guys had any experience you could share. I don't come on these boards to be then told to see my dr. I know I can talk to my dr. Dont treat people like idiots. I hope you learned a lesson to not always take everything at face value from your dr and just accept it.

    Here's another story. My mom was once diagnosed with a rare disease. They told her she had 6 months to live. Turns out he was wrong and she is fine. I was diagnosed with rheumatoid arthritis and put on some very heavy duty drugs made for cancer patients. Turned out he mixed up the blood work. I dont have rheumy.

    So, backhurtz, do you have anything to say in light of this information? I really don't want to start in internet fight. I dont even want an apology. I want to prevent you from doing this again in the future. Instead of saying, "sorry cant help go see your dr", say, "this is a dangerous med you might want to talk to your dr again. BUT if youre having any doubts, maybe I can look something up for you". Thanks for your time.

    Last edited by streetsk8er794; 12-14-2015 at 03:52 PM.

     
    Old 12-14-2015, 05:02 PM   #15
    backhurtz
    Senior Veteran
    (female)
     
    backhurtz's Avatar
     
    Join Date: Oct 2008
    Location: NY, USA
    Posts: 818
    backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
    Re: Suboxone film starting dose for pain?

    No one here is a medical doctor, and you were told several times by me and others that the dose was too high for an opiate naive person and to contact your physician BEFORE starting it.
    Others told you to consult a pharmacist, which I never would have suggested at all since you are not currently on opiates.
    It is NOT the responsibility of people posting here or any forum to suggest dosages of a medication to anyone.
    Doctors are human and can make mistakes, just as anyone else can, which is exactly why I would not give an answer about what might be a "starting dose" in your case and repeatedly told you to consult your prescriber, which YOU opted to not do, instead choosing to ask people on the internet. You are lucky you didn't o.d..

     
    The Following User Says Thank You to backhurtz For This Useful Post:
    momzworkin (12-15-2015)
    Closed Thread




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 09:53 AM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!